U.S. Invoice Secure Application

TELL US ABOUT YOUR CUSTOMERS

Please identify up to three Customers you intend to Factor
Customer #1
Company name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Average Sales per Month

Do you or the company have any of the following Loans?

Bank Loan or Revolving Line of CreditPPP LoanEIDL Loan7A Loan504 LoanMCA (Merchant Cash Advance) or Working Capital Loans
Total Amount of Any of the Loans Above:

Company Filing Documents, and Owners Drivers License, Resumes (If Available)

Cancelof
Please check the box if you do not have the above documents

I do not have

Signature*

Clear
Applicant acknowledges that the above information and documentation will be retained by U. S. Invoice Funding. Applicant hereby asserts that the information contained in this application is true and correct, and Applicant hereby authorizes U. S. Invoice Funding, its associates, agents, and/or affiliated companies to perform any credit investigation on Applicant, individually, and/or Applicant’s business or businesses, company or companies, including any associated principals, which U. S. Invoice Funding deems necessary. Applicant agrees to reimburse U. S. Invoice Funding for all costs and expenses that U. S. Invoice Funding may incur during the application process and hereby authorizes U. S. Invoice Funding to file the appropriate UCC financing statements to secure Applicant’s indebtedness.

Phone: (303) 907-6774
www.usinvoicefunding.com
All Rights Reserved
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U. S. Invoice Funding Application